Midterm Review Questions

A 16-year-old client has been in the active phase of labor for 14 hours. An ultrasound reveals that the likely cause of delay in dilatation is cephalopelvic disproportion. Which intervention should the nurse most expect in this case? A. cesarean birth B. administration of oxytocin C. administration of morphine sulfate D. darkening room lights and decreasing noise and stimulation

A

A G3P2 woman at 39 weeks' gestation presents highly agitated, reporting something "came out" when her membranes just ruptured. Which action should the nurse prioritize after noting the umbilical cord is hanging out of the vagina? A. Put her in bed immediately, call for help, and hold the presenting part of the cord. B. With the woman in lithotomy position, hold her legs and sharply flex them toward her shoulders. C. Go find the RN or health care provider to care for the client. D. Prep the woman for an emergent vaginal birth.

A

A nurse assesses a client in labor and suspects hypotonic uterine dysfunction. Which intervention would the nurse expect to include in the plan of care for this client? A. administering oxytocin B. preparing the woman for an amniotomy C. encouraging the woman to assume a hands-and-knees position D. providing a comfortable environment with dim lighting

A

The nurse is caring for a child with a fractured femur in traction. Which action will the nurse complete while caring for this client? A. ensure traction weights are hanging freely, not touching the bed or floor B. remove traction weights once per shift for 30 minutes and then replace them C. Plan to add additional weights as the fracture heals, usually once per day D. Have the assistive personnel remove the weights daily and encourage the child to move around in bed

A

The nurse is preparing the client so that the health care provider can ripen the client's cervix for induction of labor. The nurse predicts the health care provider will probably use which most commonly used mechanical method? A. Membrane stripping B. Insertion of laminaria C. PROM D. Foley bulb with extra-amniotic infusion

A

When providing discharge instructions to a client who has had a cesarean birth, which of the following points should the nurse include in the discharge plan? A. Restrictions about lifting B. Deep-breathing exercises every 2 hours C. Use of pillows to elevate the buttocks D. Benefits of Sims lateral position

A

Which of the following is the antidote for acetaminophen toxicity? A. Mucomyst B. Sodium bicarbonate C. Narcan D. Colyte

A

What does "power" refer to? Select all that apply. A. Primary contractions B. Secondary contractions C. The birth canal D. The resistance that occurs when the fetal head pushes against the cervix

A, B

During a visit to the prenatal clinic, a woman complains of heartburn. Which of the following would you recommend? Select all that apply. A. Avoid spicy foods B. Avoid lying down directly after eating C. Eat small, frequent meals D. Consume liquids only between meals

A, B, C

During a visit to the prenatal clinic, a woman complains of nausea and vomiting. Which of the following would you recommend? Select all that apply. A. Eat dry crackers B. Delay eating breakfast C. Eat small, frequent meals D. Decrease your food and fluid intake

A, B, C

Which of the following are considered part of the 7 cardinal movements? Select all that apply. A. Engagement B. Internal and external rotation C. Descent D. Extension

A, B, C, D

Which of the following parameters is included in a biophysical profile? A. Fetal reactivity B. Fetal breathing movements C. Fetal body movements D. Fetal tone E. Amniotic fluid volume

A, B, C, D, E

How will a toddler act when he or she is ready to be toilet trained? Select all that apply. A. Tug at wet diapers B. Bring clean diapers to their parents C. Will not realize when he or she is wet D. Defecate behind doors

A, B, D

A child has just been received into the clinic, and the nurse is assigned to her care. The physician determines that the child has a broken left radius, and the arm is placed in a short cast. The nurse should give the mother which of the following instructions to care for the child's cast properly? Select all that apply. A. Handle the cast only with the open palms as it drys. B. Check the child's hand function by moving the fingers and extending the thumb. C. Use a padded hanger to scratch inside the cast if itching. D. Check to see whether the fingers are warm to the touch. E. Report a foul odor around the cast.

A, B, D, E

Which of the following are included in a blended family? Select all that apply. A. Mother B. Step-father C. Grandparents D. Children E. Step-children

A, B, D, E

Which of the following reflexes are important for breastfeeding? Select all that apply. A. Rooting B. Extrusion C. Babinski D. Sucking

A, D

A child is admitted to the pediatric unit with osteomyelitis. The child is to be placed on antibiotics. The nurse expects antibiotic coverage to include which of the following as the most common cause of osteomyelitis? A. Streptococcus group B B. Staphylococcus aureus C. Haemophilus influenzae D. Mycobacterium

B

A mother is concerned why her child is not playing with other children. How would you respond? A. "This is not normal. We should teach your child how to cooperatively play." B. "This is normal. During this stage of development, toddlers play side-by-side rather than with other children" C. "I wouldn't worry about that" D. "This is not normal. I will refer you to a specialist."

B

As a nurse, how can you best decrease infant mortality rate? A. Refer couples to genetic counseling B. Promote and educate the importance of prenatal care C. Refer women to dieticians during their pregnancy D. Keep women and newborns in the hospital longer

B

Eight hours after a cesarean section, a postpartum woman is having heavy lochia. She informs the nurse, who suspects which of the following causes? A. Normal for a cesarean section B. Postpartum hemorrhage C. Infection D. Another cause other than the birth

B

How should a parent respond to their toddler's temper tantrum? A. Hug and console the toddler B. Simply disapprove and walk away C. Reward the toddler if he or she stops D. Discipline the toddler

B

Hypertonic labor is labor that is characterized by short, irregular contractions without complete relaxation of the uterine wall in between contractions. Hypertonic labor can be caused by an increased sensitivity to oxytocin. What would the nurse do for a client who is in hypertonic labor because of oxytocin augmentation? A. increase oxytocin B. turn off the oxytocin C. increase the methotrexate D. turn off the methotrexate

B

Jessica's last menstrual period was january 5 2019, when is her expected due date? A. November 12, 2019 B. October 12, 2019 C. December 12, 2019 D. October 5, 2019

B

The nurse is caring for a group of children on the pediatric unit. The nurse should collect further data and explore the possibility of child abuse in which situation? A. A 10-year-old with a simple fracture of the femur, which the caregiver reports as having been caused when the child fell down a set of stairs. B. A 7-year-old with a spiral fracture of the humerus, which the caregiver reports as having been caused when the child was hit by a bat swung by a Little League teammate. C. A 9-year-old with a compound fracture of the tibia, which the caregiver reports as having been caused when the child attempted a flip on a skateboard. D. A 6-year-old with a greenstick fracture of the wrist, which the caregiver reports as having been caused when the child fell while ice-skating.

B

What acid-base imbalance is present during pregnancy? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

B

What age is considered the fundamental age for language development? A. 1 year B. 2 years C. 2 1⁄2 years D. 3 years

B

What electrolyte level is closely monitored during pregnancy? A. Potassium B. Sodium C. Phosphorus D. Calcium

B

When should an infant develop the pincer grasp? A. 5 months B. 10 months C. 12 months D. 15 months

B

Which of the following is the priority for a woman with hyperemesis gravidarum? A. Contact precautions B. Monitoring fluid and electrolyte levels C. Assessing nausea and vomiting patterns D. Referring the woman to a dietician

B

Which of the following theorists focused on a person's social view of self? A. Freud B. Erikson C. Piaget D. Kohlberg

B

Which of the following are included in a family of orientation? Select all that apply A. Spouse B. Siblings C. Children D. Parents

B, D

A 35-year-old P1001 has been admitted for a scheduled repeat cesarean. As the nurse prepares the patient for surgery, what is the best way to begin preoperative teaching? A. Wait until the physician and the anesthesiologist have completed their history and assessment, so the teaching can be more focused and directed. B. Start by going over the risks of cesarean so she has enough time to go over each one. C. Assess how much the woman already knows about cesarean. D. Ask her husband, who is fearful and anxious, to wait outside.

C

A nuclear family includes: A. Two people living together without children B. A marriage with multiple wives or husbands C. Composed of a husband, wife, and children D. Composed of a couple, with or without children

C

A woman and her husband want to drive to california for vacation. Which of the following recommendations by the nurse would be best? A. "Try to avoid traveling anywhere in your car during pregnancy." B. "Limit the time you spend in the car." C. "Taking the vacation is a great idea as long as you stop every 1-2 hours to get up and walk." D. "Avoid wearing your seatbelt in the car to prevent injury to the fetus."

C

A woman asks you how to tell the difference between braxton hicks and true contractions. How would you respond? A. "True contractions are irregular." B. "True contractions are predictable." C. "True contractions often begin in the back and sweep around to the abdomen." D. "True contractions decrease in length and intensity over time."

C

A woman during a prenatal visit tells you she has been craving dirt throughout the day. What is your priority response? A. "Cravings as such are normal during pregnancy." B. "This is not normal." C. "I will contact your provider for an order to test your iron levels." D. "We need to increase your iron intake."

C

A woman in labor is having very intense contractions with a resting uterine tone >20 mm Hg. The woman is screaming out every time she has a contraction. What is the highest priority fetal assessment the health care provider should focus on at this time? A. Monitor heart rate for tachycardia. B. Monitor fetal movements to ensure they are neurologically intact. C. Look for late decelerations on monitor, which is associated with fetal anoxia. D. Monitor fetal blood pressure for signs of shock (low BP, high FHR).

C

A woman is wondering what her bishop score means. How would you respond? A. A bishop score assesses your stage of labor B. A bishop score assesses the 5 P's of labor C. A bishop score assesses your cervical readiness D. A bishop score tells us we need to do a cesarean section

C

An infant arrives at the emergency department with vomiting, seizures, and irritability for the last 8 hours. A radiograph confirms bleeding into the space between the dura and arachnoid membrane. What diagnosis would the nurse expect the physician to make for this patient? A. concussion B. epidural hematoma C. subdural hematoma D. skull fracture

C

How much blood would the nurse expect a woman to lose during a cesarean birth? A. 300-500 mL B. 500-750 mL C. 500-1000 mL D. 750-1200 mL

C

If a newborn's birth weight was 7 lbs, how much should the newborn weigh at 12 months? A. 14 lbs B. 10 lbs C. 21 lbs D. 24 lbs

C

If a woman is overweight, how much weight should she gain during pregnancy? A. 28 - 40 lbs B. 25 - 35 lbs C. 15 - 25 lbs D. 11 - 20 lbs

C

If the presenting part of the fetus is below the ischial spines, what would the fetal station be? A. Between -5 and -1 B. 0 C. Between +1 and +5 D. 5+

C

Shoulder dystocia is a true medical emergency that can cause fetal demise because the baby cannot be born. Stuck in the birth canal, the infant cannot take its first breath. Which maneuver is first attempted to deliver an infant with shoulder dystocia? A. McDonald maneuver B. McGeorge maneuver C. McRoberts maneuver D. McRonald maneuver

C

The nurse is monitoring a client at 41 weeks' gestation receiving IV oxytocin. Which action should the nurse prioritize if noticeable contractions are occurring every 2 minutes, lasting 60 to 90 seconds on the fetal monitor? A. administer oxygen 10L via face mask B. Change the client's position C. Stop the IV oxytocin infusion D. notify the health care provider

C

The nursing student correctly identifies the major cause of deaths in the 1-year-old to 4-year-old age group to be which of the following? A. cancer B. immunosuppressive disorders C. accidents D. congenital disorders

C

What is regression? A. When a child repeats what others do B. When a child uses their imagination to make up an imaginary friend C. When a child goes back to a behavior that was once mastered D. Regression does not occur in childhood

C

What is temperament? A. An increase in physical size or growth B. An increase in the ability to function C. The usual reaction pattern of an individual or an individual's characteristic manner of thinking, behaving, or reacting to stimuli in the environment

C

What trimester does a woman require the highest caloric intake? A. First trimester B. Second trimester C. Third trimester D. All trimesters require the same caloric intake

C

What week of gestation does a woman's iron need intensify? A. 10 weeks B. 15 weeks C. After 20 weeks D. After 30 weeks

C

Which of the following is considered the best nutritional intake for infants? A. Exclusive breastmilk for 12 months B. Formula for 12 months C. Exclusive breastmilk for the first 6 months and breastmilk and solid foods for the next 6 months D. It will differ for each family

C

Which of the following is the best position for a woman to improve comfort and circulation? A. On back B. Legs elevated C. Sim's position, on the left side D. On stomach

C

Which of the following women are at highest risk for vitamin b12 deficiency during pregnancy? A. An underweight woman B. A vegetarian woman C. A vegan woman D. An adolescent

C

A 12-year-old female client has been diagnosed with scoliosis with a curvature of 30 degrees. What type of treatment would the nurse anticipate being started on this client? A. traction B. exercise C. surgery D. bracing

D

New parents on the unit are very concerned with the shape of their newborns' head hours after birth. How would you respond? A. "This is not normal. I will contact the provider immediately." B. "I wouldn't worry because this happens a lot." C. "We will keep a close eye on it." D. "The force of the uterine contractions and passing through the birth canal often causes a change in the shape of the newborns head."

D

The nurse is educating a group of caregivers about fractures seen in children. One of the caregivers states, "I have heard that if a bone breaks it can cause permanent damage and stop the growth of the bone." This statement is accurate if the break occurs in the: A. humerus B. joint C. xiphoid process D. epiphyseal plate

D

What is considered a reactive result to a nonstress test? A. No accelerations of 15 beats by 15 seconds B. One accelerations of 15 beats by 15 seconds C. Two decelerations of 15 beats by 15 seconds D. Two accelerations of 15 beats by 15 seconds

D

What is mcdonald's rule? A. How to determine a woman's estimated due date B. When a woman should begin producing colostrum C. The fundus-to-symphysis distance in inches is considered equal to the weeks of gestation D. The fundus-to-symphysis distance in centimeters is considered equal to the weeks of gestation

D

Which of the following fontanelles are open at birth? A. Anterior B. Neither C. Posterior D. Both

D

Which of the following is most optimal for delivery? A. Shoulder presentation, longitudinal line, and flexion attitude B. Cephalic presentation, longitudinal line, and extension attitude C. Breech presentation, longitudinal line, and flexion attitude D. Cephalic presentation, longitudinal line, and flexion attitude

D